BRADLEY BIBB MD PLLC NPI 1831595057

NPI Information

NPI: 1831595057
Provider Name: BRADLEY BIBB MD PLLC

Doing Business As: ACCESS MEDICAL CLINIC

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

CLIA Number: 04D2087153

Address:
202 NEWSOME DR
MARKED TREE, AR
ZIP 72365
Phone: (870) 358-4355
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BRADLEY BIBB MD PLLC is a rural health clinic center in Marked Tree, AR. BRADLEY BIBB MD PLLC NPI is 1831595057. The provider is registered as an organization entity type.
The provider Is Doing Business As Access Medical Clinic.

The provider's business location address is:

202 NEWSOME DR
MARKED TREE, AR
ZIP 72365-021
Phone: (870) 358-4355
Fax: (870) 994-7488

The provider's authorized official is Bradley Bibb .
The authorized official title is Ceo and has the following contact phone number (870) 994-7301.

The CLIA number assigned to this NPI record is 04D2087153 - rural health clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/16/2014 and was last updated on 2/3/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR1300X	Clinic/Center	Rural Health			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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